Osteoporosis - overview

Osteoporosis is a disease in which bones become fragile and more likely to break (fracture).

Causes

Osteoporosis is the most common type of bone disease.

Osteoporosis increases the risk of breaking a bone. About one half of all women over the age of 50 will have a fracture of the hip, wrist, or vertebra (bones of the spine) during their lifetime. Spine fractures are the most common.

Your body needs the minerals calcium and phosphate to make and keep healthy bones.

During your life, your body continues to both reabsorb old bone and create new bone.

As long as your body has a good balance of new and old bone, your bones stay healthy and strong.

Bone loss occurs when more old bone is reabsorbed than new bone is created.

Sometimes, bone loss occurs without any known cause. Other times, bone loss and thin bones run in families. In general, white, older women are the most likely to have bone loss.

Brittle, fragile bones can be caused by anything that makes your body destroy too much bone, or keeps your body from making enough new bone. As you age, your body may reabsorb calcium and phosphate from your bones instead of keeping these minerals in your bones. This makes your bones weaker.

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A major risk is not having enough calcium to build new bone tissue. It is important to eat enough high-calcium foods. You also need vitamin D, because it helps your body absorb calcium. Your bones may become brittle and more likely to fracture if:

If you do not eat enough food with calcium and vitamin D

Your body does not absorb enough calcium from your food, such as after gastric bypass surgery

Osteoporosis is a rare disease of the bones.

The correct answer is myth. Osteoporosis is the most common type of bone disease. People with osteoporosis develop weak bones that can break easily. Finding and treating osteoporosis early before bones become too weak can help prevent breaks.

Osteoporosis develops when:

The correct answer is both. Even though bones are hard, they are living tissue. The body is constantly building new bone tissue to replace the bone tissue it uses up. If it can't do this fast enough, the bones become weak and brittle. Aging, too little calcium, or certain health problems can cause bone loss.

In the early stages, a common sign of osteoporosis is:

The correct answer is none of the above. There are no symptoms in the early stages of osteoporosis. Many times, a bone break is the first sign of the disease. This is why people at risk should be tested for osteoporosis. Ask your doctor about your risk for osteoporosis.

Osteoporosis often causes fractures of the:

The correct answer is all of the above. About half of all women over the age of 50 will have a fracture of the hip, wrist, or vertebra during their lifetime because of bone loss. Menopause is a good time to talk with your doctor about your risk of osteoporosis and how to reduce it.

Osteoporosis can make you shorter.

The correct answer is fact. Over time, osteoporosis can cause many small breaks along the spine. These breaks in the vertebrae can gradually cause back pain, stooped posture, and a loss of up to 6 inches of height. Your doctor can detect these breaks with an x-ray of the spine.

The best osteoporosis screening measures the amount of bone in the:

The correct answer is lower spine and hip. Your doctor uses a type of X-ray machine to test you for osteoporosis. You might see small X-ray machines in pharmacies or at health fairs. They can measure bones in the finger, wrist, leg, or heel, but are not as accurate as the X-ray machine your doctor uses.

Which lifestyle change can help prevent and treat osteoporosis?

The correct answer is all of the above. Your body needs calcium to build bone. To build strong bones, you should get enough calcium in your diet starting in childhood or early adulthood. Dairy products have the most calcium. Smoking and alcohol use reduces bone strength. Talk with your doctor about how to prevent osteoporosis.

Osteoporosis medicines can reduce the risk of fractures.

The correct answer is fact. Bisphosphonates (Fosamax, Boniva, Actonel , or Reclast) are used to prevent and treat bone loss. They help make the bones in your hips, spine, and other areas stronger. You may take a pill weekly or monthly or have an IV infusion once a year. Talk with your doctor about the pros and cons of this medicine.

Your doctor will prescribe medicine only if you already have osteoporosis.

The correct answer is false. Your doctor may also prescribe medicine if you have had a bone fracture and a bone test shows your bones are thinner than normal bones. The goal is to prevent another bone fracture by building up your bones.

To reduce the risk of falls, people with osteoporosis should:

The correct answer is all of the above. Hip fractures are one of the main reasons people have to go into nursing homes. If you have osteoporosis, and even if you don’t, avoiding falls and fractures can help you stay independent. Talk with your doctor about other ways to prevent falls.

Symptoms

There are no symptoms in the early stages of osteoporosis. Many times, people will have a fracture before learning they have the disease.

Fractures of the bones of the spine can cause pain almost anywhere in the spine. These are called compression fractures. They often occur without an injury. The pain occurs suddenly or slowly over time.

Compression fractures

Compression fractures of the back are broken vertebrae. Vertebrae are the bones of the spine.

There can be a loss of height (as much as 6 inches or 15 centimeters) over time. A stooped posture or a condition called a dowager's hump may develop.

Exams and Tests

A DEXA scan is a low-radiation x-ray that measures the density of the minerals in your bones. Most often, it measures density in the spine and hip bones. Your health care provider uses this test to:

Diagnose bone loss and osteoporosis.

Predict your risk for future bone fractures.

See how well osteoporosis medicine is working. (The DEXA is most often repeated every 2 years.)

A simple spine or hip x-ray may show fracture or collapse of the spinal bones. However, simple x-rays of other bones are not very accurate in predicting whether you are likely to have osteoporosis. A new low-radiation spine x-ray called a vertebral fracture assessment (VFA) is now often done with a DEXA to better identify fractures that do not have any symptoms.

You may need blood and urine tests if your provider thinks the cause of your osteoporosis is a medical condition, rather than the slow bone loss that occurs with aging.

DEXA scan results compare your bone mineral density with both a young adult who has no bone loss and with people your age and gender. This means that at age 80, almost one third of women with normal age-related bone loss would have osteoporosis, based on their DEXA scan results.

Treatment

Treatment for osteoporosis may involve:

Making lifestyle changes, such as changing your diet and exercise routine

Taking calcium and vitamin D supplements

Using medicines

Medicines are used to strengthen bones when:

Osteoporosis has been diagnosed by a bone density study, whether or not you have a fracture and your fracture risk is high.

Bone density study

A bone mineral density (BMD) test measures how much calcium and other types of minerals are in an area of your bone. This test helps your health care...

A calcium supplement

Follow a diet that provides the proper amount of calcium and vitamin D.

Your provider may recommend higher doses of vitamin D if you have risk factors for osteoporosis or a low level of this vitamin.

(Note: Some expert groups are not sure the benefits and safety of these amounts of vitamin D and calcium outweigh their risks. Be sure to discuss with your provider whether supplements are a good choice for you.)

North American Menopause Society. Management of osteoporosis in postmenopausal women: 2010 position statement of The North American Menopause Society. Menopause. 2010;17(1):25-54. PMID: 20061894 www.ncbi.nlm.nih.gov/pubmed/20061894.

Osteoporosis

Animation

Related video goes here for no-HTML5 browsers

Related video goes here for no-HTML5 browsers

Osteoporosis - Animation

Osteoporosis is a condition that leads to loss of bone mass. From the outside, osteoporotic bone is shaped like normal bone. However, the inside of the bones becomes more porous during the aging process due to the loss of calcium and phosphate. The loss of these minerals makes the bones more prone to fracture even during routine activities, like walking, standing, or bathing. Often, a person will sustain a fracture before becoming aware of the presence of the disease. Prevention is the best measure for treating osteoporosis, by eating a recommended balanced diet including foods with sufficient amounts of calcium, phosphorous, and vitamin D. In addition, maintaining a regular exercise program as approved by your health care provider will help to keep the bones strong. Various medicines can be used as part of the treatment for osteoporosis and should be discussed thoroughly with your health care provider.

Osteoporosis

Animation

Related video goes here for no-HTML5 browsers

Osteoporosis - Animation

If you've ever watched an apartment or office building under construction, you've seen the metal scaffolding that keeps the building standing upright. Inside your body, bones are the scaffolding that keep you standing upright. As you get older, these supports can weaken. And if they get too weak, you could wind up with a fracture. Let's talk about the bone-thinning condition called osteoporosis. Your internal scaffolding was built when you were young. Calcium and other minerals helped strengthen your bones, provided that you got enough of them from your diet. As you get older, those minerals can start to leech out of your bones, leaving them brittle, fragile, and easily breakable, a condition known as osteoporosis. Women over 50 are especially at risk for osteoporosis because during menopause they lose estrogen, which helps to keep bones strong. The tricky part about osteoporosis is that it's hard to tell you have it. You may not have any symptoms until you've already fractured a bone. Getting a bone density scan, which measures bone thickness, is one way to find out whether you have osteoporosis so you can start treatment right away if you need it. To keep your bones strong, try to get at least 1,200 milligrams of calcium daily, paired with 1,000 international units of vitamin D, which helps your body absorb calcium. You can eat foods that are high in these nutrients, like frozen yogurt, salmon, and low-fat milk, or, if you're not a big fan of fish or dairy, you can take supplements. Weight bearing exercise is also your ally when it comes to strengthening bones. A combination of weight bearing exercises like walking or playing tennis, plus strength training and balance exercises will reduce your risk of getting a fracture if you fall. You will want to get at least thirty minutes of exercise three times a week to see the benefits. And, stop smoking. Cigarette smoke both accelerates bone loss and blocks treatments from being as affective. If you've been diagnosed with osteoporosis, your doctor may recommend drugs called bisphosphonates to prevent further bone damage. Other medicines, including calcitonin, parathyroid hormone, and raloxifene are also treatment options. Don't let bone loss get so far along that you could have a disabling fracture from a minor fall. Start strengthening your bones with diet and exercise while you're still young. As you get older, talk to your doctor about bone density scans, and ask whether you need to take medicine if you're at risk for, or are starting to show signs of osteoporosis. And if your bones aren't as strong as they used to be, avoid falls by wearing shoes that fit well, and clearing clutter on the floor before it can trip you up, and bring you down.

Compression fracture - illustration

In a compression fracture the body of the bone tissue of the vertebra collapses. This can occur because of trauma or a disease process such as osteoporosis or a tumor.

Compression fracture

illustration

Bone density scan - illustration

A bone density scan measures the density of bone in a person. The lower the density of a bone the higher the risk of fractures. A bone scan, along with a patient's medical history, is a useful aid in evaluating the probability of a fracture and whether any preventative treatment is needed. A bone density scan has the advantage of being painless and exposing the patient to only a small amount of radiation.

Bone density scan

illustration

Osteoporosis - illustration

Osteoporosis is a condition characterized by progressive loss of bone density, thinning of bone tissue and increased vulnerability to fractures. Osteoporosis may result from disease, dietary or hormonal deficiency or advanced age. Regular exercise and vitamin and mineral supplements can reduce and even reverse loss of bone density.

Osteoporosis

illustration

Osteoporosis - illustration

Osteoporosis is a condition characterized by progressive loss of bone density, thinning of bone tissue and increased vulnerability to fractures. Osteoporosis may result from disease, dietary or hormonal deficiency or advanced age. Regular exercise and vitamin and mineral supplements can reduce and even reverse loss of bone density.

Osteoporosis

illustration

Hip fracture - illustration

Hip fractures occur as a result of major or minor trauma. In elderly patients with bones weakened by osteoporosis, relatively little trauma, even walking, may result in a hip fracture.

Hip fracture

illustration

Vitamin D source - illustration

Like most vitamins, vitamin D may be obtained in the recommended amount with a well-balanced diet, including some enriched or fortified foods. In addition, the body manufactures vitamin D when exposed to sunshine, and it is recommended people get 10 to 15 minutes of sunshine 3 times a week.

Vitamin D source

illustration

Calcium benefit - illustration

Calcium requires adequate vitamin D in order to be absorbed by the body. In the United States, many food sources of calcium such as milk are fortified with vitamin D.

Calcium benefit

illustration

Calcium source - illustration

Getting enough calcium to keep bones from thinning throughout a person's life may be made more difficult if that person has lactose intolerance or another reason, such as a tendency toward kidney stones, for avoiding calcium-rich food sources. Calcium deficiency also effects the heart and circulatory system, as well as the secretion of essential hormones. There are many ways to supplement calcium, including a growing number of fortified foods.

Calcium source

illustration

Bone-building exercise - illustration

Exercise plays an important role in the retention of bone density in the aging person. Studies show that exercises requiring muscles to pull on bones cause the bones to retain and possibly gain density.

Bone-building exercise

illustration

Changes in spine with age - illustration

The spine weakens with age, becoming more curved and more fragile.

Changes in spine with age

illustration

Osteoporosis

Animation

Related video goes here for no-HTML5 browsers

Related video goes here for no-HTML5 browsers

Osteoporosis - Animation

Osteoporosis is a condition that leads to loss of bone mass. From the outside, osteoporotic bone is shaped like normal bone. However, the inside of the bones becomes more porous during the aging process due to the loss of calcium and phosphate. The loss of these minerals makes the bones more prone to fracture even during routine activities, like walking, standing, or bathing. Often, a person will sustain a fracture before becoming aware of the presence of the disease. Prevention is the best measure for treating osteoporosis, by eating a recommended balanced diet including foods with sufficient amounts of calcium, phosphorous, and vitamin D. In addition, maintaining a regular exercise program as approved by your health care provider will help to keep the bones strong. Various medicines can be used as part of the treatment for osteoporosis and should be discussed thoroughly with your health care provider.

Osteoporosis

Animation

Related video goes here for no-HTML5 browsers

Osteoporosis - Animation

If you've ever watched an apartment or office building under construction, you've seen the metal scaffolding that keeps the building standing upright. Inside your body, bones are the scaffolding that keep you standing upright. As you get older, these supports can weaken. And if they get too weak, you could wind up with a fracture. Let's talk about the bone-thinning condition called osteoporosis. Your internal scaffolding was built when you were young. Calcium and other minerals helped strengthen your bones, provided that you got enough of them from your diet. As you get older, those minerals can start to leech out of your bones, leaving them brittle, fragile, and easily breakable, a condition known as osteoporosis. Women over 50 are especially at risk for osteoporosis because during menopause they lose estrogen, which helps to keep bones strong. The tricky part about osteoporosis is that it's hard to tell you have it. You may not have any symptoms until you've already fractured a bone. Getting a bone density scan, which measures bone thickness, is one way to find out whether you have osteoporosis so you can start treatment right away if you need it. To keep your bones strong, try to get at least 1,200 milligrams of calcium daily, paired with 1,000 international units of vitamin D, which helps your body absorb calcium. You can eat foods that are high in these nutrients, like frozen yogurt, salmon, and low-fat milk, or, if you're not a big fan of fish or dairy, you can take supplements. Weight bearing exercise is also your ally when it comes to strengthening bones. A combination of weight bearing exercises like walking or playing tennis, plus strength training and balance exercises will reduce your risk of getting a fracture if you fall. You will want to get at least thirty minutes of exercise three times a week to see the benefits. And, stop smoking. Cigarette smoke both accelerates bone loss and blocks treatments from being as affective. If you've been diagnosed with osteoporosis, your doctor may recommend drugs called bisphosphonates to prevent further bone damage. Other medicines, including calcitonin, parathyroid hormone, and raloxifene are also treatment options. Don't let bone loss get so far along that you could have a disabling fracture from a minor fall. Start strengthening your bones with diet and exercise while you're still young. As you get older, talk to your doctor about bone density scans, and ask whether you need to take medicine if you're at risk for, or are starting to show signs of osteoporosis. And if your bones aren't as strong as they used to be, avoid falls by wearing shoes that fit well, and clearing clutter on the floor before it can trip you up, and bring you down.

Compression fracture - illustration

In a compression fracture the body of the bone tissue of the vertebra collapses. This can occur because of trauma or a disease process such as osteoporosis or a tumor.

Compression fracture

illustration

Bone density scan - illustration

A bone density scan measures the density of bone in a person. The lower the density of a bone the higher the risk of fractures. A bone scan, along with a patient's medical history, is a useful aid in evaluating the probability of a fracture and whether any preventative treatment is needed. A bone density scan has the advantage of being painless and exposing the patient to only a small amount of radiation.

Bone density scan

illustration

Osteoporosis - illustration

Osteoporosis is a condition characterized by progressive loss of bone density, thinning of bone tissue and increased vulnerability to fractures. Osteoporosis may result from disease, dietary or hormonal deficiency or advanced age. Regular exercise and vitamin and mineral supplements can reduce and even reverse loss of bone density.

Osteoporosis

illustration

Osteoporosis - illustration

Osteoporosis is a condition characterized by progressive loss of bone density, thinning of bone tissue and increased vulnerability to fractures. Osteoporosis may result from disease, dietary or hormonal deficiency or advanced age. Regular exercise and vitamin and mineral supplements can reduce and even reverse loss of bone density.

Osteoporosis

illustration

Hip fracture - illustration

Hip fractures occur as a result of major or minor trauma. In elderly patients with bones weakened by osteoporosis, relatively little trauma, even walking, may result in a hip fracture.

Hip fracture

illustration

Vitamin D source - illustration

Like most vitamins, vitamin D may be obtained in the recommended amount with a well-balanced diet, including some enriched or fortified foods. In addition, the body manufactures vitamin D when exposed to sunshine, and it is recommended people get 10 to 15 minutes of sunshine 3 times a week.

Vitamin D source

illustration

Calcium benefit - illustration

Calcium requires adequate vitamin D in order to be absorbed by the body. In the United States, many food sources of calcium such as milk are fortified with vitamin D.

Calcium benefit

illustration

Calcium source - illustration

Getting enough calcium to keep bones from thinning throughout a person's life may be made more difficult if that person has lactose intolerance or another reason, such as a tendency toward kidney stones, for avoiding calcium-rich food sources. Calcium deficiency also effects the heart and circulatory system, as well as the secretion of essential hormones. There are many ways to supplement calcium, including a growing number of fortified foods.

Calcium source

illustration

Bone-building exercise - illustration

Exercise plays an important role in the retention of bone density in the aging person. Studies show that exercises requiring muscles to pull on bones cause the bones to retain and possibly gain density.